The most common cause of chronic pancreatitis is?

Long term alcohol abuse(TOPNOTCH)

This condition is characterized by parenchymal fibrosis, reduced number and size of acini with relative sparing of the islets of Langerhans, and variable dilation of the pancreatic ducts.

Chronic Pancreatitis(TOPNOTCH)

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What is the most constant morphological feature of Chronic Pancreatitis?

Acinar Loss(TOPNOTCH)

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60% of cancers of the pancreas arise in what area?

Head > Body > Tail(TOPNOTCH)

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What is the most frequently altered oncogene in pancreatic cancer?

K-RAS (TOPNOTCH)

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What is the most frequently inactivated tumor suppressor gene in pancreatic cancer?

p16(TOPNOTCH)

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What is the strongest environmental risk factor for developing Pancreatic Cancer?

Smoking(TOPNOTCH)

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What are the two characteristic features of Pancreatic Cancer?

Highly invasive and it elicits an intense non neoplastic host reaction called a desmoplastic response(TOPNOTCH)

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Where do Pancreatic cancers usually metastasize?

Lungs and bones(TOPNOTCH)

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This variant of Pancreatic cancer is characterized by formation of zymogen granules and the production of exocrine enzymes including trypsin and lipase`

Acinar cell carcinoma(TOPNOTCH)

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What is the first symptom of pancreatic cancer?

Pain(TOPNOTCH)

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These structures are formed by the walling off of areas of peripancreatic hemorrhagic fat necrosis with fibrous tissue and are usually composed of central necrotic hemorrhagic material rich in pancreatic enzymes surrounded by non epithelial lined fbrous w

Activation of trypsinogen and subsequent autodigestion of the pancreatic substances(TOPNOTCH)

2 most common causes of acute pancreatitis

A 32 y/o male presented with abdominal pain, nausea, and vomiting. Pain was described as constant and intense with radiation to the upper back. Lab result showed elevated plasma amylase. The clinical impression is:

Clinical features include intermittent or persistent abdominal pain, intestinal malabsorption, and diabetes. It is characterized by irreversible injury of the pancreas.

A 53 y/o male, smoker, presented with abdominal pain, weight loss, and jaundice since 1 month. The abdominal CT revealed a mass on the pancreas. What part of the pancreas is most likely affected?

Head of the pancreas. Obstructive jaundice is associated with most cases of carcinoma of the head of the pancreas. (TOPNOTCH) Robbins Basic Pathology, 9th ed. P. 894

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Migratory thrombophlebitis occuring in pancreatic cancer due to elaboration of PAF and procoagulants from the carcinoma or its necrotic products.

Trosseau sign(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 894

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Most patients with this disease present with abdominal pain and weight loss, sometimes accompanied by jaundice and DVT, and succumb to the disease within 1 to 2 years.

Pancreatic cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 895

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Poorly defined cyst with a necrotic brown-black wall, lacks epithelial lining. It is usually solity and may be situated within the pancreas or in the lesser omental sac or in the retroperitoneum. Formed when areas of intrapancreatic or peripancreatic hemorrhagic fat necrosis are walled off by fibrous tissue and granulation tissue.

A 44 year old alcoholic woman has been having intermittent postprandial epigastric pain of 5 years. An imaging study done showed a solitary 3 cm cyst at the anterior portion of his pancreatic head. Fearing the worst, she opts to undergo a Whipple procedure, and the definitive specimen showed a cyst with a smooth internal surface and surrounding fibrosis. Microscopic examination showed a cyst wall lined by fibrin, granulation tissue, and chronic inflammation. There is no epithelial lining observed. The cyst (A) is a common sequela of acute pancreatitis (B) is hormonally responsive to estrogen (C) is a precursor to pancreatic adenocarcinoma (D) is known to harbor K-RAS mutations